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06/26/2018PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION
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Anyone who wishes to obtain a state residential licensure needs to fill out the form. This form is typically required by individuals who want to engage in residential activities in a specific state, such as renting, buying, or leasing residential properties, or applying for residential permits or certifications.
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